Abstract: Oral malignancy necessitates early detection for a better prognosis. Clinical presentation may vary, from a small mucosal lesion with benign clinical features to a large ulcerated mass with considerable local destruction. The case of a 46-year-old patient presenting to a dental access centre with upper quadrant jaw pain, parasthaesia and unexplained tooth mobility is discussed. Delay in recognizing key features suggestive of sinister pathology led to a seven-week delay in referral of an aggressive, rare, odontogenic malignancy; ameloblastic carcinoma. The patient underwent extensive surgery with adjunctive radiotherapy.

Clinical relevance: Odontogenic malignancy can cause rapid and extensive local invasion with a high potential for local or regional spread. Maxillary tumours often present with late, non-specific symptoms, thus must be detected early.